Legionellosis investigation ongoing in Niagara County

In October, the Niagara County Department of Health received notification from Eastern Niagara Hospital in Lockport that a cooling tower tested positive for Legionella bacteria exceeding 1000 CFU/mL (colony-forming units per milliliter). NCDOH continues to collaborate with the New York State Department of Health on the ongoing investigation of a cluster of 13 cases of Legionellosis in the community.

The NCDOH is facilitating testing of all other cooling towers and potential sources of Legionella in the area. No laboratory evidence to date establishes a definitive link between ENHS and the cluster of cases.

Niagara County DOH has reported two of the people with Legionellosis have died.

"Our heartfelt condolences go out to the families of these individuals," said Daniel J. Stapleton, Niagara County public health director. "We continue to use every expert staff resource available to investigate for a possible source of these infections, including the assistance and guidance of the NYSDOH division of epidemiology. The NCDOH public engineers have inspected 41 facilities with 90 cooling towers to ensure compliance with NYS bacterial monitoring regulations. Several have been rechecked."

Under new regulations adopted this past summer, owners of cooling towers are required to notify NCDOH and NYSDOH of any water samples testing positive for Legionella bacteria.

ENHS collected water samples as part of routine cooling tower monitoring for Legionella. Immediately after receiving the positive test result, ENHS disinfected the cooling tower and retested the water. Laboratory tests showed this process was successful in remediating bacteria levels in the water.

"Our department continues to monitor Eastern Niagara Hospital for any changes in this situation," Stapleton said. "Our mission is to protect the health of our community."

Legionellosis is caused by infection with Legionella bacteria. Multiple potential sources are being investigated, such as cooling towers, water tanks, large plumbing systems and fountains. Most of the time, results are negative for Legionella bacteria.

Legionella is typically transmitted by breathing in aerosolized water contaminated with the bacteria, not by drinking the water. Public water systems are usually not found to be the source of Legionella outbreaks.

Most healthy individuals do not get sick after inhaling the bacteria. People at highest risk for Legionellosis have a history of chronic disease, smoking, chronic lung disease, cancer or weakened immune systems. 

In New York, including New York City, 200-800 cases are diagnosed annually. Most Legionella cases are identified in the summer and early fall, but can occur at any time of year. The increased awareness and focus on Legionnaires' disease has prompted increased testing, detection and diagnosis by health providers. This does not necessarily indicate an increase in the number of Legionella cases in New York.

Two common methods are used to test patients for legionella: a urine antigen test and a sputum test. A urine antigen test is less invasive for patients. A sputum test requires collecting a sample from a patient's lungs and airway, and can be difficult and traumatic to obtain.

A sputum sample containing Legionella bacteria is required to match a Legionella case to an environmental source. The process of growing a culture from sputum takes several days. If the person received antibiotic therapy prior to collection of the sputum sample, determining a match may not be possible. Growing a culture from sputum is difficult in general.

View a Legionellosis fact sheet at:http://www.health.ny.gov/diseases/communicable/legionellosis/fact_sheet.htm

"We may not find the source, but our investigation will not end until we have taken all steps necessary to find answers," Stapleton said.